A significant proportion of women with polycystic ovaries have regular menstrual pattern and no overt symptoms or signs of hyperandrogenism. These women are thought to be healthy, while the incidental ultrasound finding of polycystic ovaries is dismissed as a normal variant. Recent studies, however, challenge these traditional views. A minority of these women exhibit anovulation or biochemical hyperandrogenism and, currently, qualify as having polycystic ovary syndrome (PCOS). Even ovulatory women with polycystic ovaries exhibit mild hormonal and metabolic disturbances compared to the normal female population of reproductive age. In view of the recognized long-term health consequences (type II and gestational diabetes, obstructive sleep apnoea, hyperlipidemia, hypertension) in women with hyperandrogenism and insulin resistance, it is important to further characterize this particular group of asymptomatic women with polycystic ovaries that do not fulfill the current diagnostic criteria for PCOS.